Downbeat nystagmus
Written and reviewed by Dr Ibrahim Imam, Consultant Neurologist. Last reviewed .
Downbeat nystagmus. This is nystagmus typified by slow upward drifts and fast downwards phases. Fully referenced neurology checklist.
Clinical features
- This is nystagmus typified by slow upward drifts and fast downwards phases
- It is poorly suppressed by visual fixation
- It may be evoked by looking down and outwards
- It shows a variable response to convergence
- It may be worsened by the head hanging position
Idiopathic types
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Neurodegenerative causes
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Autoimmune causes
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Drug-induced
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Other causes
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Functional magnetic resonance imaging (MRI)
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Treatment
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References
- Wagner JN, Glaser M, Brandt T, Strupp M. Downbeat nystagmus: aetiology and comorbidity in 117 patients. JNNP 2008; 79:672-677.
- Serra A, Leigh RJ. Diagnostic value of nystagmus: spontaneous and induced ocular oscillations. JNNP 2002; 73:615–618.
- Hüfner K, Stephan T, Kalla R, et al. Structural and functional MRIs disclose cerebellar pathologies in idiopathic downbeat nystagmus. Neurology 2007; 69:1128-1135.
- Helmchen C, Machner B, von der Gablentz J, Sprenger A, Zee DS. Downbeat nystagmus is abolished by alcohol in nonalcoholic wernicke encephalopathy. Neurol Clin Pract 2022; 12:e129-e132.
- Serra A, Chisari CG, Matta M. Eye movement abnormalities in multiple sclerosis: pathogenesis, modeling, and treatment. Front Neurol 2018; 9:31.
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